Incident investigation·April 25, 2022

This unannounced case management visit is being conducted by Licensing Program Analyst (LPA) Ruth Martinez to follow up on an incident reported to Community Care Licensing. LPA arrived at facility was greeted by receptionist and granted entry. LPA met with Jennifer Suckiel, administrator and explained the purpose of today’s visit. Incident was self reported on 03/14/2022 regarding R1’s incidents on 03/08/2022. On 03/08/2022 R1 activated red alert pendant, facility nurse responded to the call. Upon arrival nurse observed R1 to be on the floor of the residents apartment kitchen. R1 reported to have hit the back of the head and a small laceration was observed. Facility nurse conducted first aid to R1 until paramedics arrived on scene. 911 was immediately called and paramedics arrived on seen and transferred R1 to local hospital for evaluation. R1 indicates that they felt light-headed and just fell back, R1 does not have a history of falls. R1 denies the loss of consciousness. All responsible parties were notified and R1 returned to the community. Facility conducted a Wellness check upon return to the facility. R1 followed up with primary physician. R1 has been doing well since incident. LPA found that facility acted appropriately and in a timely manner to address the incident and all other immediate attention to injuries in question. LPA did not observe any immediate and/or safety risks in or out of the facility. Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations . This report was reviewed with Administrator and a copy of this report was provided and left at the facility.